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Pakistan

The Muslim-majority state of Pakistan is one of the most populous countries in the world, with more than 190 million people living within its borders.

Government restrictions and sporadic violence pose operational challenges in Pakistan. The presence of armed militant groups and ongoing counter-terrorism operations hamper humanitarian access and there is a general distrust of aid workers.

Mother and Child Health

Healthcare for women and children is a serious concern in Pakistan. Women in rural areas die from preventable complications during pregnancy and delivery, and neonatal care is unavailable in many areas.

Near the Afghan border, MSF works with the Ministry of Health providing reproductive, newborn and paediatric healthcare. The team also manages an emergency room and offers inpatient and outpatient nutritional support for malnourished children under the age of five. These services are available to local residents, Afghan refugees and people who cross the border seeking medical assistance.

MSF operates a comprehensive 24-hour emergency obstetric care service at Peshawar women’s hospital for patients referred from surrounding districts and Federally Administered Tribal Areas (FATA). Teams also run an outpatient therapeutic feeding program through a network of mobile clinics and outreach sites.

According to the Pakistan Demographic and Health Survey, one in every 11 children dies before the age of five

In Timergara, around 200 kilometres north of Peshawar, MSF supports the district headquarters hospital’s emergency department and also provides comprehensive emergency obstetric care.

Healthcare in Machar Colony

Karachi’s Machar Colony slum is densely populated, with around 150,000 people living in polluted conditions and facing a lack of clean water and waste disposal. MSF conducts outpatient consultations at the clinic it runs in collaboration with SINA Health Education & Welfare Trust and provides diagnosis and specialised treatment for hepatitis C, which is highly prevalent in Pakistan. The team also manages uncomplicated births and offers mental health counselling and health promotion.

Over 41% of Karachi's population lives in unregulated neighbourhoods (katchiabadis) - Machar Colony is amongst the biggest.

Home to waves of refugees and economic migrants who have settled over the past two decades in the former fishing village, the illegal slum houses thousands of people who live in squalid conditions without access to safe water or medical facilities. Migrants in Pakistan do not have access to advanced medical treatment under the government health system.

In 2017, the authorities in Kurram and Bajaur informed MSF that the certificate required for carrying out medical activities in Federally Administered Tribal Areas (FATA) would not be renewedbut gave no explanation for this decision. Before the closure, MSF was responsible for the paediatric outpatient and inpatient departments. Teams also ran the neonatal unit, and treated patients with the parasitic skin disease cutaneous leishmaniasis.

It is likely that the closure of these medical facilities - delivering free, high-quality healthcare - will have serious negative implications for people who rely on them.